Antiresorptive treatments for corticosteroid-induced osteoporosis: a Bayesian network meta-analysis

Br Med Bull. 2022 Sep 22;143(1):46-56. doi: 10.1093/bmb/ldac017.

Abstract

Introduction: Corticosteroid-induced osteoporosis (CIO) is the most common type of secondary osteoporosis, leading to fractures, and increased morbidity and mortality.

Source of data: Pubmed, EMBASE, Scopus and Google Scholar databases.

Areas of agreement: Prolonged glucocorticoids administration leads to secondary osteoporosis.

Areas of controversy: The optimal management for CIO is controversial.

Growing points: The present study compared bone mineral density, fractures and adverse events in patients undergoing treatment with risedronate, alendronate, zoledronate, denosumab or etidronate for CIO.

Areas timely for developing research: For selected patients with CIO, alendronate performed better overall. These results must be interpreted within the limitations of the present study.

Level of evidence: I, Bayesian network meta-analysis of randomized clinical trials.

Keywords: BMD; alendronate; corticosteroid; drugs; fracture; osteoporosis.

Publication types

  • Meta-Analysis

MeSH terms

  • Adrenal Cortex Hormones* / adverse effects
  • Alendronate / adverse effects
  • Bayes Theorem
  • Bone Density Conservation Agents / adverse effects
  • Denosumab / adverse effects
  • Etidronic Acid / adverse effects
  • Glucocorticoids / adverse effects
  • Humans
  • Network Meta-Analysis
  • Osteoporosis* / chemically induced
  • Osteoporosis* / complications
  • Osteoporosis* / drug therapy
  • Risedronic Acid / adverse effects
  • Zoledronic Acid / adverse effects

Substances

  • Adrenal Cortex Hormones
  • Bone Density Conservation Agents
  • Glucocorticoids
  • Denosumab
  • Zoledronic Acid
  • Risedronic Acid
  • Etidronic Acid
  • Alendronate